147 – Margaret Learns How to Paint: 15 January 2025

Because I decided to force the health insurers to obey the law, Margaret gained an additional 20 months of life and had a painting lesson on 15 May 2022.  Margaret is in the exact middle.

****

The surgeon had scheduled yet another operation on Margaret for Wednesday 1 December 2021.  The cancer had vanished from the lymph nodes, but it was still there and the primary source of the cancer in her ampullar was still present.

The 1 December operation took place as scheduled.  The news from the surgeon could hardly have been more dismal.

He had not been able to administer endoscopic radiotherapy to try and blast the cancer because the inflammation in Margaret’s digestive system had not gone down but increased.  The inflammation had prevented endoscopic radiotherapy during the previous operation and the medication since then was supposed to have got rid of the inflammation so the radiotherapy could go ahead on 1 December.  The surgeon’s written said this.

Gastroscopy Findings Stomach – Normal. Duodenum – Normal         Duodenal Papilla Major Papilla – The 2 old stents were seen. The ampullar was markedly ulcerated and the duct/ biliary orifice were widely opened.  This looked like radiation therapy to the area and this has led to a patent duct. Cannulation of PD was not successful again. The CBD was cannulated and opened a marked dilation in the proximal portion (up to 20 mm).  There were lots of filling defects which was a mixture of sludges/ stone fragments and airbubble on balloon trawl. Good drainage via the biliary orifice was seen, thus, no stenting was required. Conclusion Patent CBD, no stent required. PD no accessible.  No RFA treatment

****

The medical language in the report was not easy to understand, but the oral report the surgeon gave to Margaret was very clear. 

The cancer was thriving and Margaret should expect the cancer to kill her sooner rather than later.

****

The surgeon decided he would perform yet another operation on Friday 3 December.  He hoped to find out more about the growth of the cancer.  This meant Margaret was trapped in the hospital.  If Margaret returned home from hospital, the government restrictions surrounding Covid meant she would not be readmitted to the hospital in two days’ time on 3 December.

My visit to Margaret on 2 December after the 1 December operation was hard for both of us.  I wheeled her in a wheelchair to the hospital coffee shop.  While we were in the coffee shop.  Margaret pointed to the part of the hospital which housed the Palliative Care Unit.  She also spoke about Mary Potter Hospice; Mary Potter is a ward in that hospital dedicated to the care of the dying.  She said she would visit Palliative Care and Mary Potter after I went home.  When I rang Margaret later that day, she told me she had been to Palliative Care and Mary Potter, that the staff were extremely helpful and that she had done all necessary paperwork to use their services.

We were so very close to the end, but Margaret was still completely composed and dealing efficiently with the administrative detail to enable her to die with as much dignity as possible.

****

So that was how we were dealing with Margaret’s likely death in the evening of that Thursday 2 December 2021.

In the very near future, the cancer would kill her and she was doing everything she could to make my life after her death and just before it, as straightforward as she could. 

That night I began thinking about Margaret’s funeral.  What should I say?  What music did I want during the service? 

My sleep was terrible that night.  I woke up at 3:00 am on Friday morning, mentally repeating what had happened on the Thursday morning.  Realising that staying in bed would not get me any extra sleep, I got up, walked for an hour, breakfasted and read the newspaper.  Doing things to “keep me busy" made the hours pass, but so very slowly.

****

My thoughts that morning kept returning to the behaviour of the health insurance funds.

Margaret had been receiving treatment all year at Lift Cancer Care Services and the treatment had obviously helped keep her alive.

About two months earlier (I think it was in October 2021) Lift told Margaret that some insurers were refusing to pay for the treatments provided by Lift Cancer Care Services.  As from 1 December, Lift needed all patients insured by HCF, NIB and teachers’ Health to pay in full for the treatments they received on the day they got the treatments. 

On 2 December, I knew Margaret was going to die in the very near future, so the refusal of the health insurers to obey the law would not be of concern to me for very long.  If Margaret lived long enough to ever need any more treatments at Lift, I could somehow find the money to pay for the treatments. 

No matter what I did, Margaret was going to die very soon and the actions of the health insurers would not really matter to me into the future.  But I kept thinking of the other cancer patients who received treatments at Lift.  How were they going to receive their treatments if the health insurers kept refusing to pay and if they did not have money in the bank to pay out of their own pockets?  

They would die much more quickly than they should if they could not get the treatments their doctors wanted them to get.

I wondered, should I take action to help these other cancer patients get the treatment they needed?  In the great fog of sorrow about Margaret’s impending death, my determination crystalised.  I had to do something; I could not let the actions of greedy health insurers cause needless deaths. 

I decided to write to HCF and the Commonwealth Ombudsman.  I imagined – wrongly – that the refusal to pay would be fixed as soon as I complained.  If HCF refused to obey the law, the Commonwealth Ombudsman was certain to force it to obey the law.

****

I was wrong.  The Commonwealth Ombudsman knew what was going on and had refused to enforce the law.

HCF and the other health insurers knew the Commonwealth Ombudsman had no intention of enforcing the law.  This knowledge reinforced their refusal to obey the law.  What bank robber will ever stop robbing banks when the robber knows the police will never do anything to stop the robber from robbing the banks?

****

I had no way of knowing early in that morning of 3 December 2021 that my determination to force the health insurers to obey the law would have a direct impact on Margaret’s continued life.

I wrote my first letters in what became a very long struggle to enforce the law – and Margaret got an immediate reprieve from imminent death.  By deciding to help other patients, I ensured Margaret received an additional 20 months of life.

 

146 – Margaret’s Lymph Node Cancer Disappears: 13 January 2025

This was how Margaret looked in Ireland on 17 September 2019.  By October 2021, she was dying and no longer looked like this.

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Ireland on 17 September 2019.

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The findings of the 29 September operation were a little inconclusive, but they were not good. 

****

As I have already said, I simply do not have the words to describe how I felt after getting the news of what the surgeon found when he operated on 29 September 2021. 

Although the surgeon had been unable to administer radiotherapy during his operation on Margaret on 29 September 2021, he was able to implant two stents into her bile duct.  His medical words summed up what he had done:

The biliary duct was stented with 2 plastic stent[s] and this resulted in good contrast and bile drainage

The surgeon had wanted to also insert a stent into Margaret’s pancreatic duct, but the swelling in the pancreatic duct was so great that he was unable to do this.  He said “the PD could not be entered”. 

This is how the health website Healthline describes a stent.

[A] stent is a tiny tube that your doctor can insert into a blocked passageway to keep it open. The stent restores the flow of blood or other fluids, depending on where it’s placed.

 ****

By 29 September, the cancer had not only returned, it had grown and was starting to block Margaret’s bile duct.  Without the two stents to keep the bile duct open, her digestive system would have been unable to function.  Her swift death would have been certain.

Unfortunately, a stent could not be placed in her pancreatic duct because the surgeon was worried this would cause pancreatitis.  Pancreatitis is an extremely serious disease.  The Mayo Clinic says this about pancreatitis.

Pancreatitis is inflammation of the pancreas. The pancreas is a long, flat gland that sits tucked behind the stomach in the upper abdomen. The pancreas produces enzymes that help digestion and hormones that help regulate the way your body processes sugar (glucose). Pancreatitis can occur as acute pancreatitis — meaning it appears suddenly and lasts for days. Some people develop chronic pancreatitis, which is pancreatitis that occurs over many years. Mild cases of pancreatitis improve with treatment, but severe cases can cause life-threatening complications.

The surgeon had a difficult dilemma when he operated on 29 September.  If he ensured the pancreatic duct could continue to function he might cause life threatening pancreatitis.  If he avoided possible pancreatitis this would leave Margaret at risk of the blockage of her pancreatic duct.

The surgeon decided to avoid pancreatitis and Margaret told me later that she completely agreed with the surgeon’s decision.

Because of inflammation in the pancreatic duct, the operation was able to gather only meagre information about the spread of the cancer. 

****

After receiving the PET scan report, the surgeon scheduled a further operation for 1 October 2021.  He wanted to discover what the cancer was doing.

This is the surgeon’s report on the 1 October 2021 operation.

Gastroscopy Findings Stomach – Normal.  Duodenum – Normal.  The ampulla has 2 plastic stents[s] which drained bile. EUS Findings Upper GIT: 1 The nodal lesion on the left of the celiac axis was seen.  It measured up to 20 mm.  The lesion looked malignant and as requested, the lesion was biopsied using EUS FNA technique.  Two passes of 22G Core needles were performed for histology. 2 The liver was also screened careful[ly] for mass lesion but no definite lesion can be seen in the visualised portion. 3 There was a cyst in the pancreatic head/ neck region.  The cyst looked benign and had no malignant features. 4 The PD was 2-3 mm in calibre. 5 CBD stents had decompressed the biliary tract. Conclusion Metastatic nodal disease EUS FNA = Endoscopic Ultrasound Fine Needle Aspiration

 ****

The PET scan report ensured the “nodal lesion” which had so concerned the surgeon on 14 and 29 September was a major focus of attention on 1 October.  The surgeon found the “lesion looked malignant”.  His written conclusion was “Metastatic nodal disease”.

Margaret seemed certain to die soon.

On 1 October the surgeon took tissue samples so the suspicious cells could be tested.

Although concerned about the lymph nodes, the surgeon thought Margaret’s liver was still cancer free.

He also found that a growth in the head of the pancreas was not cancerous.  

The only good news was that the bile duct stents had worked and the cancerous squeezing of the bile duct (“compression”) had been reversed.

****

The stents had gained Margaret some extra time, but her situation was grim.  The surgeon gave her medication to reduce inflammation in her pancreas and scheduled another operation fir Wednesday 1 December 2021.  He hoped the inflammation would have decreased by then and that he would be able to administer endoscopic radiotherapy.

We prepared ourselves as best we could.  The cancer was certain to kill Margaret – sooner rather than later.

****

Then something astonishing happened.

When the tissue samples taken from the lymph nodes on 1 October were examined in the laboratory, they were cancer free. 

Despite the result of the PET scan and despite what the surgeon saw on 29 September and 1 October, Margaret’s lymph node tissue was cancer free.

The oncologist had no explanation for this. 

I have an “unscientific” explanation of my own for what happened.  I believe the stress of my health collapse had a direct impact on Margaret.

I think the stress of having to deal with my near death on top of her own cancer, was the major reason why Margaret’s cancer returned in September 2021.

I believe I can thank the Cancellation Crew for my own health collapse and for the return of Margaret’s cancer.

As for the disappearance of the cancer from Margaret’s lymph nodes – this was quite simply a miracle just like the many other miracles recorded throughout history.

We were immensely grateful.

 

 

145 – Margaret’s Cancer Spreads to Her Lymph Nodes: 12 January 2025

This was how Margaret looked on 27 April 2019.  By September 2021, she was dying and she no longer looked like this.

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Margaret had another endoscopic ultrasound on Tuesday 14 September 2021.  The report of the operation was optimistic.  The report said this.

 

Findings On endoscopy, the ampulla was small but has some polypoid/ villiform tissue at the orifice.  Biliary discharge was noted.  The ampulla was biopsied using a forcep. On EUS, the ampullary mass is barely noticeable and has reduced in size to 8 mm the max.  There was no obvious extension of tumour into the distal CBD or PD.  Neither duct was dilated (CBD 7 mm and PD 1-2 mm).  Overall, the appearance suggestive of ongoing remission!. The previous 2 cystic lesions[s] within the pancreas: neck (23 mm) and tail (8 mm) were both seen.  Both has no high risk or worrisome features. The previously enlarged node in the celiac axis, measuring up to 15 mm was again see and was hypoechoic.  This it was biopsied using EUS FNA technique.  Material was collected for histology. EUS = Endoscopic Ultrasound; CBD = Common Bile Duct; PD = Pancreatic Duct

****

This operation confirmed that the cancer remained in remission, but it raised a question about its possible presence in the lymph nodes.  This would be resolved by the tissue sample the surgeon sent for testing. 

On 23 September, the oncologist told us that the tissue sample taken from the lymph nodes was indeed cancerous.  The terrible news was that the cancer was now present in Margaret’s lymph nodes.

The Cancer Council of Australia says this about lymph nodes.

Lymph nodes or lymph glands, are part of the lymphatic system which is part of both the immune and circulatory systems. The lymphatic system consists of lymph vessels, lymph fluid and lymph nodes and other lymph tissue.    Lymph nodes are small, bean-shaped structures that are found along the lymph vessels. They filter lymph fluid as it passes through your body before emptying into the bloodstream. Lymph fluid, which is normally clear, travels to and from the tissues in your body. It carries nutrients but also takes away harmful substances such as bacteria, viruses, cell debris and abnormal cells such as cancer cells. The filtered fluid is returned to your blood circulation.

 

The lymph nodes are, in effect, a separate “blood stream” containing lymph fluid instead of blood.  A cancer which is present in the lymph nodes, has access to virtually every part of the body.  It can grow and prosper throughout the body. 

The surgeon scheduled another operation for a further endoscopic ultrasound for Wednesday 29 September.

****

Margaret had a PET (Positron Emission Tomography) scan on Monday 27 September.  The $950.00 cost of this procedure was not covered by either Medicare or our private health insurer.  The imagery produced by a PET scan is extremely detailed.  Margaret’s PET scan was so detailed, it highlighted a “hot spot” on her arm where she had received a Covid vaccination one week earlier.  Here are some extracts from the PET scan report.

Lymph Nodes: A focus of intensive uptake FDG uptake, SUV max 5.6 is noted at the left para-aortic lymph node (level of L 2/3), suspicious of modal metastasis. Another focus of moderate grade FDG uptake SUV max 4.9 is noted at right pelvis, (see key image), raising suspicion of nodal metastasis. CONCLUSION: The intense focal activity anterior to the vena cava, at level of L 4, is suspicious of ampullary malignancy, given adjacent dilated common bile duct on low dose CT … Correlation with gastroscopy and/ or endoscopic ultrasound is suggested if clinically indicated.  Differential diagnosis includes a precaval lymph node at the level of L 4. 1          FDG avid nodal metastases in the left para-aortic region and possibly in right pelvis as outlined above. 2          The low grade focal activity in the liver, may be due to physiological variable liver uptake, although early liver metastasis not completely excluded.  No obvious liver lesion is seen on separate CT today … Follow up +/ - MRI is suggested if clinically indicated. 3          Foci of bowel uptake as outlined above.  Correlation with colonoscopy to exclude benign or malignant polyps before attributing them to physiological bowl uptake is suggested if clinically indicated.

****

The website Radiology in Plain English says “FDG is a radioactive sugar that is used in PET imaging.  The idea is that FDG is taken up more in abnormal tissues then normal ones.  That is, abnormal tissues use glucose or sugar more than normal ones.  This is reflected in PET scans as more uptake and a hotter or brighter tissue on the scan.”

Margaret’s PET scan report confirmed a high uptake of FDG in her lymph nodes.  This was a clear indication that the cancer had spread to the lymph nodes. 

****

We both tried to digest this terrible news.  The cancer had spread to Margaret’s lymph nodes.

This surely meant she was doomed and her death would probably happen before the end of 2021.

****

Another operation took place on 29 September, just two days after the PET scan.  The aim of this operation was to enable the surgeon to “zap” the cancer with radiotherapy administered inside Margaret’s body through an endoscope. 

The surgeon was unable to administer any radiotherapy.

The findings of the 29 September operation were a little inconclusive, but they were not good. The written report from the surgeon said this.

 

Duodenal Papilla Major Papilla – due to previous radiation therapy, the ampulla was markedly deformed with ulceration.  The biliary and pancreatic duct orifices could not be identified. Whilst the CBD was successfully cannulated, the PD could not be entered despite the use of different cannuli and wires.  Given the risk of pancreatitis is high without PD stenting, RFA was not performed.  A sphincterotomy (5 mm) followed by balloon dilation of the distal CBD stricture was performed.  The CBD was markedly dilated (up to 30 mm).  The biliary duct was stented with 2 plastic stent[s] and this resulted in good contrast and bile drainage. CONCLUSION Ampullar cancer causing a tight stricture at the distal CBD.  PD not accessible and thus, cannot be stented.  No RFA due to high risk of pancreatitis. CBD = Common Bile Duct PD = Pancreatic Duct RFA = Radiofrequency Ablation; Cannulation = insertion of a stent

****

The cancer had stayed in remission only until I had ceased being in danger of imminent death.  Once my life was safe, the cancer roared back into vigorous life.  It was determined to end Margaret’s life as quickly as possible

I do not have the words to describe how truly horrible this news was.

 

144 – The Cancellation Prize: 11 January 2025

This photo shows the complete list of friends who came to wish us Happy Christmas on 25 December 2021.  

Margaret's sister Maurine Redden had visited me in hospital and given me the three stuffed toys.  Our 2021 Christmas was extremely dismal.

****

Before getting home after my final hospitalisation on 15 July, my mind was very focused just on staying alive.  I knew Margaret had incurable cancer, but she had been granted a miraculous reprieve from death in March 2021.  I hoped this meant her death sentence had been removed.  I was wrong in thinking this, but in July and August 2021, I was unaware just how wrong I was.

Once I got home and my health began to steadily improve, I became more observant of things that were happening in our lives apart from Margaret's cancer and my own health.

When she told me on 8 February that she was severing all ties of friendship with me, Anne Ryan pointedly said that even though she was terminating her friendship with me, she “hoped she could remain friends with Margaret”.  I did not process this statement at that time because I had difficulty digesting my own cancellation. 

By August 2021, I began to realise that the statement that she “hoped she could remain friends with Margaret” was a doublespeak way of saying “I will no longer be friends with Margaret.”  She had already decided to cancel Margaret when she decided to cancel me – but she was too gutless to say this either to me or to Margaret.  There was an additional layer to the cancellation of Margaret and that additional layer involved making sure that all of Margaret’s other friends – every one of whom she had been introduced to by Margaret – also cancelled both of us.

The implications of what Anne had done became apparent to me after I got home from hospital in July 2021.

****

As July and August elapsed, I became aware that Sue Chaman – whom Margaret had known for about 50 years – had completely stopped visiting our home.  Prior to February 2021, she had always been a regular visitor.  Sue had become the closest of friends with Anne over the years and she was certainly Anne’s lover by 2021.

Anne had made sure that Sue stopped visiting her dying friend whom she had known for decades before she ever met her Anne.

Margaret told me that on 8 February when Anne had told me of my cancellation, Sue had waited on the street in her car while Anne told me of my cancellation.  Sue had then driven Anne back to her unit in Glenelg.  Sue and Anne had jointly decided on what Anne and Sue were going to do.

After 8 February, Sue stopped all contact with me – but unlike Anne, she did not get around to telling me of my cancellation.  During the months that I was gravely ill and close to death, I had no contact from Sue Chapman.

Just as her lover Anne did, Sue did not openly terminate her friendship with Margaret.  She simply reduced that friendship to a shell which contained nothing.

Margaret tried to hide it, but I had been aware that the behaviour of her so called friends had caused extreme distress to Margaret, but there was nothing I could do about their behaviour.

In July 2021, Margaret was in temporary remission from a deadly cancer and she had been completely sidelined by pretend friends because she was married to me.

I had come close to dying before Margaret, and I too had been completely shunned by people I had once believed were my friends.

****

Margaret’s friend Heather Long seemed to find it more difficult than Sue Chapman to behave atrociously towards Margaret and me.  Margaret had also known Heather Long for about 50 years. 

Heather did not immediately cease all contact with me and she did not immediately lessen her contacts with Margaret.  Heather even sent me a text wishing me happy birthday while I was in hospital. 

Heather did not immediately reduce her friendship with Margaret to an empty shell, but did have a dilemma.  Because Anne and Sue refused visit Margaret in our home, in practice, Heather was also a rare visitor in Margaret's home.

Because of the boycott instituted by her friends, Margaret could see her friends only away from our home – usually in coffee shops.  As the months rolled on, the coffee shop catch ups became ever rarer.

Heather’s final attempt to simultaneously be a friend to both Margaret and me and to Anne Ryan and Sue Chapman took place on Sunday 22 August 2021 when she invited Margaret and me, plus other members of the friendship group, to a restaurant dinner to celebrate her husband Andrew Long’s birthday.  

Anne boycotted the dinner because I had been invited, but Sue Chapman came.

Other guests at the restaurant in addition to Andrew and Heather Long were Chris Reilly, Cheryl Scopazzi and Nes Fernandez.

By the time Margaret and I got home after dinner on 22 August 2021, I knew very clearly that the friendship circle had been smashed and it would probably never be repaired.

 

143 – Moving Away from the Drain, Part 1: 10 January 2025

1st photo Anne Ryan and the wooden chest I restored for her; 2^nd photo, the Jarrah table.

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My Third Time in Hospital - July 2021

After the disappearance of Dr Kannusamy on 8 July, Dr Aiyappan took charge of my hospital medical care.

Dr Aiyappan ordered an extensive range of tests and scheduled a colonoscopy for the following Tuesday - 13 July.  The colonoscopy found nothing of note.  

Dr Aiyappan was determined to find out why I was so ill. and by the morning of the following Tuesday – before the colonoscopy – he had worked out what had gone wrong. 

I was being attacked by my own immune system.  

Our immune system contains white blood cells which attack intruders such as diseases.  A significant number of the white blood cells which make up the immune system are a type of white blood cell called eosinophils.

My body was producing an extraordinarily high number of eosinophils. 

My immune system had decided my body was under attack and had therefore made a large supply of white blood cells to protect me.  The large number of eosinophils made by my body formed part of my body’s determination to protect me from attack an attack by microscopic “bad guys”.  Unfortunately, there were no “bad guys” for my immune system to kill.  My body was not under attack by any disease.  Because there was no external enemy to be eliminated, the eosinophils in my immune system attacked the only thing that could be attacked – and that was - me.

By trying to protect me, my own body had come extremely close to killing me.

****

This is what Wiki says about eosinophils.

Eosinophils, sometimes called eosinophiles or, less commonly, acidophils, are a variety of white blood cells and one of the immune system components responsible for combating multicellular parasites and certain infections in vertebrates. Along with mast cells and basophils, they also control mechanisms associated with allergy and asthma. They are granulocytes that develop during hematopoiesis in the bone marrow before migrating into blood, after which they are terminally differentiated and do not multiply. These cells are eosinophilic or "acid-loving" due to their large acidophilic cytoplasmic granules, which show their affinity for acids by their affinity to coal tar dyes: Normally transparent, it is this affinity that causes them to appear brick-red after staining with eosin, a red dye, using the Romanowsky method. The staining is concentrated in small granules within the cellular cytoplasm, which contain many chemical mediators, such as eosinophil peroxidase, ribonuclease (RNase), deoxyribonucleases (DNase), lipase, plasminogen, and major basic protein. These mediators are released by a process called degranulation following activation of the eosinophil, and are toxic to both parasite and host tissues. In normal individuals, eosinophils make up about 1–3% of white blood cells, and are about 12–17 micrometres in size with bilobed nuclei.

 

                                                                       ****

Here is my personal theory of what happened to me.  I claim no medical expertise and this theory may not be valid – but it fits the facts as known to me and none of the facts contradict my theory.

The restoration of Anne Ryan’s Jarrah table and wooden chest made of King Billy Pine caused my body to ingest large quantities of the disease resistant substances created by these native Australian timbers.  These substances prevent native timbers from being turned into compost in the short time frames it takes to do this with most trees.  The ingestion of these substances nearly killed me while I was engaged in the restoration projects, but my body coped because the projects took only a few weeks.

When Margaret was diagnosed with terminal cancer in July 2020, the native timber “stuff” in my body was again activated and this triggered my original breath attacks, stomach bloating and related symptoms. 

Once Margaret’s cancer “disappeared” in March 2021, my symptoms should have disappeared, but this did not happen because of the appalling behaviour of our supposed friend Anne Ryan.  The stress of Anne’s awful behaviour significantly boosted the impact of the stuff I had ingested while restoring Anne’s wooden furniture.  This boosting meant my symptoms did not disappear at all but began to spin wildly out of control. 

The distress caused by the bad behaviour of a formerly long time friend should not have caused me any serious health problems, but on this occasion it completely destroyed my health and nearly resulted in my death.

The law has a principle used to assess how much money in damages should be awarded to someone who has been wrongfully injured.  

If the injured person is more susceptible to harm that an “normal” person would be, the person who inflicts the wrong is not allowed to limit the amount that must be paid by claiming that a “normal” person would not have suffered such extensive injuries.  The law says “you take your victim as you find the victim”.  

Anne might not have intended to do quite as much harm as she did, but this is irrelevant.  She DID intend to do some harm and must therefore accept responsibility for ALL of the harm she actually caused. 

****

Once he had identified the cause of my illness, Dr Aiyappan prescribed a medication which ended the civil war within my body.

As long as I have an injection every four weeks, my life is unlikely to again be endangered by rogue eosinophils. 

My final discharge from hospital happened on Thursday 15 July 2022. 

Since my discharge, I have experienced no symptoms and I have been in good physical health.  I am able to eat all meals, take all recommended exercise and my weight is at the recommended level.

I owe my continued life to the care of a competent and compassionate doctor called Vinod Aiyappan.

 

142 – Moving Away from the Drain, Part 1: 9 January 2025

This was me on Tuesday 9 September 2019 in Ireland, two months before I started losing weight under the supervision of a dietician.  Note the size of my stomach.  I weighed at least 105 kilograms then – 30 kilograms more than I weighed when I went into hospital in July 2021.

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My Third and Final Hospitalisation - July 2021

My final hospital admission took place on Saturday 3 July.  I had rung the rooms of my lung specialist on Thursday 1 July asking for an urgent consultation with Dr Aiyappan.  Dr Aiyappan was on holidays, but the rooms promised to tell him about my plight. 

Dr Aiyappan rang me no more than 2 hours later and promised to find me a hospital bed.  Dr Aiyappan persuaded the hospital to admit me once again, this time on the Saturday morning. 

I was in extremely bad health when admitted and Dr Aiyappan saw me in the hospital even though he was on leave.  Under his orders, a lung function test took place later that day.  This test involves the patient blowing air into various tubes to measure how much air the lungs are processing.  My lung function test said that my lungs had only 42% of the capacity of “normal” lungs.  I am certain my breathing during the test was actually better than my breathing had been in the 3 weeks since my June 2021 hospital admission.  I desperately wanted to get a "good" result and I tried hard to produce a “good” result; I was actually trying much harder during the test than I was normally able to do outside the test environment. 

I am certain my actual capacity was significantly less than the 42% measured in the test.

****

My weight was regularly measured while I was in hospital and I wrote down the results.

Between the morning of Friday 2 and Sunday 4 July, I dropped 1.3 kilograms in weight.  This Table outlines my weight in July 2021.

July 2021
Date	Weight
Friday 2 July	75.0 kilograms
Sunday 4 July	73.7 kilograms
Sunday 11 July	76.1 kilograms
Friday 16 July	76.6 kilograms
Friday 23 July	76.4 kilograms
Friday 30 July	77.2 kilograms

 

In the three weeks and five days between Sunday 4 July and Friday 30 July, I gained 3.5 kilograms (7 pounds, 11.46 ounces).  The weight increase shows the success of this final period of hospitalisation – especially when compared to the June 2021 period of hospitalisation.

****

Before my July hospital admission, I had a prearranged appointment with my cardiac specialist Dr Goh on Monday 5 July.  Even though I was still an admitted hospital patient, I took a taxi to the appointment with Dr Goh.  I gave him the medication list I had already given to the hospital staff.  Dr Goh immediately said that the combination of Amitriptyline Alphapharm with Aspirin was dangerous and that I must not continue to take the Aspirin.  Dr Goh then gave me a handwritten a note in a sealed envelope and told me to give it to the hospital staff immediately I returned to hospital.

As well as giving me the note, Dr Goh ordered that I be given an Echocardiogram (Echo) test as soon as possible after I got back to hospital.  It was obvious to me that Dr Goh was very concerned that my hospital treatment was ignoring my known and documented heart disease.

I delivered the note from Dr Goh to the nursing station when I returned to hospital and stressed Dr Goh’s insistence that I must not be given any further Aspirin.  The Echo test on my heart was carried out later on that same Monday.  Nothing of significance was uncovered by the Echo test.

The note by Dr Goh initiated the treatment changes which led to my diagnosis and correct treatment, but the only noticeable immediate changes he brought about were the stopping of the Aspirin and the Echo test.

****

Dr Aiyappan did a bronchoscopy on Wednesday 8 July 2021.  It revealed no abnormalities.

****

Although I had been admitted to hospital by Dr Aiyappan, I had been placed under the care of Dr Dinesh Kannusamy, who had been my hospital doctor during my June hospitalisation.  Dr Kannusamy saw me again in the morning of Tuesday 6 July and prescribed a new medication on top of the Amitriptyline Alphapharm he had prescribed in June.  I cannot now remember the name of this additional medication, but I am now certain it was another anti depressant.  I reluctantly took the additional pill as instructed by Dr Kannusamy on Tuesday 6 and Wednesday 7 July.  The nursing staff may also have given me this additional anti depressant on Thursday 8 July.  

I had never suffered from depression and had never been diagnosed as suffering from depression.

Dr Aiyappan visited me in hospital in the early morning of Thursday 8 July and I told him I did not want to take the new medication and asked him if he could terminate it.  My intention was to first get rid of the new anti depressant and then ask to have the Amitriptyline Alphapharm terminated as well.  Dr Aiyappan said that he would see what he could do.

****

Shortly after Dr Aiyappan left my room– perhaps ten or fifteen minutes later – a new doctor whom I had never seen before, entered my room.  I cannot now remember his name but my health insurance claims history tells me I was treated on 9 July by Dr Boey, so the new doctor was probably Dr Boey.  Dr Boey (if he was in fact the new doctor) was wonderful.

The doctor confirmed that I did indeed want to terminate the new medication and then immediately gave instructions to staff to do that.  My hospital treatment changed noticeably after the visit by Dr Boey.

In my room, there was a small whiteboard where the name of my treating doctor was written at the top.  Dr Kannusamy’s name was written on this whiteboard.  Later, on that Thursday, Dr Aiyappan’s name was written immediately under Dr Kannusamy’s name.  Although Dr Kannusamy’s name remained on the whiteboard, I never saw him again. 

On Friday 10 July, Dr Boey visited me again and recommended discontinuation of the Amitriptyline Alphapharm.  He said Amitriptyline Alphapharm was a “very old fashioned” medication and that it was “highly addictive”.  I agreed and he had the Amitriptyline Alphapharm discontinued over the next three days.

****

I did not know it then, but my health was about to improve quickly now that I was in compassionate and competent medical care.

I was about to have a miracle cure.